Acupractitioner21 is the sequel to the underground hit Acustudent21, from one of the periods when I was training in Chinese medicine. This blog will focus on Classical Chinese Medicine, CCM, the old system, and on what it´s like to practice acupuncture in the West in the 21st century. The name might have changed, but like everybody in old Chinese medicine, I am still a student.

söndag 11 september 2011

Autumn and acupuncture, weiqi, and the change of seasons in the Neijing

We are heading into Autumn now. And as should be part of all acupuncture, we will look at how to help patients change more smoothly with the seasons.

Chinese medicine was created from Daoism, and is deeply influenced by it. In the Neijing, The Yellow Emperor´s Internal Classic, the bible of Chinese medicine, the first two chapters talk a lot about how important it is to move with the seasons and the changes in nature. This theme then goes all through the Suwen and the Lingshu, the two parts that make up the book – the General Questions and the Spiritual Pivot.

The Chinese medical classics creates the theoretical backbone for information that is taught in a clinical setting, in depth, over long time, by an acupuncture doctor or practitioner to their students.

Part of chapter 1 is a go-through of different levels of Daoist training and how the practitioners there would see the world. It ends with how wise but more normal people should see things to maximize their health.

”Next, those who could preserve their health to the state of being ”a wise and good man”. They could master and apply the way of preserving health in accordance with the variation of heaven and earth, such as with the different locations of the sun, the waxing and waning of the moon, the distribution of the stars, the mutual contradiction of yin and yang and the alternation of the four seasons. They mastered and practised the ways of preserving health, sought to tally with the ways of preserving health in ancient times, so they could also prolong their lives to the maximum limit.”

When we move more smoothly with the seasons, our health will be at its best. It also means that we truly enjoy and savour each season – we become more present in the season instead of feeling like we are fighting our way through it until the next one comes along.

Most people have at least one season they feel out of synch with. Sometimes this means that their body reacts badly to it too, like the one season you always get a cold in, or feel bad in, or just wish is over now. That usually indicates the season you have the most problems with, often related to the Five Elements that build up your system.

A skilled acupuncturist won´t force the patient´s system into synch with the seasons, but instead gently aid their system to follow the seasons naturally by itself. Again, this is the way to use ziran, naturalness, from Daoism, to just help the system instead of trying to force it to adjust.

”When a sage treats a patient, precaution is always emphasized, and often uses preventive measures in calming down disturbances. If the disease is treated after it has already been formed, or if you try to calm down the disturbance after it has already taken shape, it will be too late, just like to dig a well after one is thirsty, or to cast the weapon after the war has already broken out.”

– Neijing, Wu and Wu, Chapter 2

Part of this classic quote is to understand how to move with the seasons better – giving treatments without even giving a treatment. On top of this, acupuncture or herbs can help with it even more in the hands of an acupuncturist trained in how to help the patient move more smoothly with the seasons. Chapter 2 of the Neijing goes into great detail about how each season affects us, and how treatments can help. It then continues on this theme into chapter 3 and echoes through the rest of the book.

If the patient can be helped to move more ziran, naturally, with the seasons, they will enjoy each season more fully and have better health all throughout the year. If their system works like this, any problems from a season will not stay in the body and risk becoming a long-time issue down the line. That view goes back to the quote here above about preventive medicine, something which has been seen as the highest skill in Chinese medicine all the way since at least 3-400 BC.

Chapter 3 then goes on to describe how it works when it works well: When the human energy is connected with that of the universe, the human temperament will be fresh and cool in a calm circumstance where there is no strong wind and rain-storm. With the calm circumstance, one can keep his spirit quiet and clear as the blue sky, refrain from the disturbances of overjoy or violent rage. By this time, his bodily yang energy is substantial, and will not be hurt even though being attacked by evil factors. This is due to his ability of adapting the sequence and variations of the four seasons to preserve his health in a good way.

– Neijing, Wu and Wu, Chapter 3

”His spirit quiet and clear as the blue sky” is a Daoist saying, and in Daoist spiritual training there are techniques for creating this. The phrase ”evil factors” – liuxie, the Six Evils – is an old term from early Chinese medicine. In very old times, it was more mixed with shamanism, and the external things that could affect us – wind, dryness, heat, summer heat, damp and cold – also could contain evil spirits. Today, the more common (if drier) term in English is usually the Six External Pathogenic Factors. This writer prefers using the Six Evils as a name anyway, it sounds better.

All the information about the seasons in the Neijing can be summarized with one word: change, bianhua, which is what Daoism studies. The writers of the texts have just used more words and similies to try to illustrate the importance of learning to move with change in the seasons, and how important it is to be able to help patients do this. Most likely they had their own practices for it, using qigong and meditation, practices that still exist in Daoism today, and they might even have taken for granted that any clinician reading the text would be deeply steeped in the same training. Daoism researches change, and has a whole spectrum of qigong- and meditation-practices based around it. This work is what slowly leads the practitioner to study Dao itself, which always changes yet contains stillness within that change.

Once the seasons are better understood, we move into how to help patients treat the seasons of their life. This goes back to the Five Elements of Daoism and Chinese medicine; each season in life will be treated differently by a skilled acupuncturist, just as each season is during a year.

In one of the oldest text we have from Daoism, the Neiye, the Classic of Internal Training, it is describes what Daoist practices should give the long-time practitioner:

Therefore, the Sage:

alters with the seasons but doesn´t transform,

shifts with things but doesn´t change places with them.

– Neiye, Original Tao, Inward Training and

the Foundations of Taoist Mysticism, Harold Roth, 1999.

The way of adapting to the seasons with acupuncture then keeps being discussed and mentioned in the Nanjing, The Classic of Difficulties, in Difficulty Seven. The Nanjing is is a Chinese medical classic that takes later physicians´ questions and summarizes them to give clearer answers, including on some debated points from the much earlier Neijing. The Seventh Difficult Issue asks about how to define which times of the year affect the meridians in different ways, and how nature moves energy through them in the body.

The quote above from the Neijing chapter 3 very kindly goes on to describe what happens when people don´t follow the seasons:

Therefore, as a sage can keep his essence of life and energy in concert with the yang energy of heaven, thus can communicate this energy with the divinity of heaven. But, unfortunately, most people run in the opposite direction to it, so, whenever he is assaulted by evil factors, his nine orificies become obstructed internally, and his muscle contracts disease of stagnation externally, even his weiqi becomes dispersed. This is due to his inability of adapting to the sequence and variations of the four seasons.

– Neijing, Wu and Wu, Chapter 3

Weiqi translates as ”protective energy”, something we will look at now, as it is important in how Autumn works in us.

Autumn is linked to the Metal Element of the Five Elements. Metal links to the spine, skin, lungs, airways, nose and breath. It links to grief, but also the other side of it – the incredible clear happiness of being alive. If we get too much grief for our system to handle, the spine starts slumping around the lungs, thus containing the grief there even more instead of just letting it go.

Metal creates borders, structure, lines. It also creates the border between us and our surroundings; this needs to be balanced to work well – not too strong, not too weak.

The weiqi is the most external of the body´s energy. It is an external energy field that goes all around living beings, usually about two-three centimeters at most in normal humans, often with holes and blockages in it. There are specific ways of healing and cleaning up the weiqi using specific qigong-practices. The weiqi then goes down to the subcutaneous layers of the skin. It is created by the lungs, but important for acupuncturists to know is that it´s the energy of the kidneys that is the foundation for this. If the energy in our system is low, the lungs won´t have enough energy to convert to weiqi. Balancing the lungs will help, but essentially it comes down to the stability of the kidneys and the links to and from them in our post-heaven qi.

There are also specific techniques for stimulating the weiqi itself using acupuncture.

In Chinese medicine, the weiqi is seen as part of our immune system. When our health is weak, the weiqi becomes weaker too; we get more easily influenced by our surroundings, or by viruses. In a very ill person, the weiqi virtually disappears as all energy is pulled into their body to try to nourish it.

In autumn, the weiqi should be alive and well, slowly closing to protect our systems for the cold of winter. It is seen as very bad for our health if we get a cold in the Fall and it lingers on in our body into winter.

A skilled acupuncturist must deeply study the seasons and how they affect their own system – what it´s like to be passionately alive in them, healthy in them, and enjoying them. The better they are at this, the better they can help their patients move with the seasons themselves. Once you move more easily with the seasons, become more alive with the seasons, this not only gives you better health all through the year but gives you wisdom to understand how to fully live in and enjoy all the seasons of life.